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https://www.readbyqxmd.com/read/29333893/syringe-administration-of-epinephrine-by-emergency-medical-technicians-for-anaphylaxis
#1
Andrew J Latimer, Sofia Husain, Jonathan Nolan, Vinod Doreswamy, Thomas D Rea, Michael R Sayre, Mickey S Eisenberg
OBJECTIVE: In recent years, the costs of epinephrine autoinjectors (EAIs) in the United States have risen substantially. King County Emergency Medical Services implemented the "Check and Inject" program to replace EAIs by teaching emergency medical technicians (EMTs) to manually aspirate epinephrine from a single-use 1 mg/mL epinephrine vial using a needle and syringe followed by prehospital intramuscular administration of the correct adult or pediatric dose of epinephrine for anaphylaxis or serious allergic reaction...
January 15, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29332503/-they-said-on-the-death-certificate%C3%A2-but-really-what-i-think-happened-characterizing-cause-of-death-in-va-medical-centers
#2
Beverly Rosa Williams, F Amos Bailey, Patricia S Goode, Kathryn L Burgio
Cause of death information is a vital resource for family and public health, yet significant issues persist regarding its determination, documentation and communication. In this study, we aim to characterize cause of death attribution process from the perspective of next-of-kin of Veterans who died in Veterans Affairs (VA) Medical Centers. Using a semi-structured guide, we explored next-of-kin's experiences of the Veteran's terminal hospitalization and conducted a content analysis of interview texts. In over two-third of cases next-of-kin's understanding was not consistent with their recollection of physicians' determination of cause of death...
January 1, 2018: Journal of Palliative Care
https://www.readbyqxmd.com/read/29331270/severe-beta-blocker-and-calcium-channel-blocker-overdose-role-of-high-dose-insulin
#3
Karan Seegobin, Satish Maharaj, Ansuya Deosaran, Pramod Reddy
A 54-year-old female presented after taking an overdose of an unknown amount of hydrochlorothiazide, doxazocin, atenolol and amlodipine. She was initially refractory to treatment with conventional therapy (intravenous fluids, activated charcoal, glucagon 5 mg followed with glucagon drip, calcium gluconate 10%, and atropine). Furthermore, insulin at 4 U/kg was not effective in improving her hemodynamics. Shortly after high dose insulin was achieved with 10 U/kg, there was dramatic improvement in hemodynamics resulting in three of five vasopressors being weaned off in 8 h...
January 10, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29330890/audit-of-referrals-for-concern-regarding-labial-appearance-at-the-royal-children-s-hospital-2000-2012
#4
Sarah K McQuillan, Yasmin Jayasinghe, Sonia R Grover
AIM: To audit the clinical features and outcomes for all patients referred to our centre with concerns regarding labial appearance. METHODS: Young females referred to a paediatric/adolescent gynaecology tertiary centre between 2000 and 2012 with concerns regarding their labial appearance were retrospectively identified. Adolescents presenting with anomalies were excluded. Retrospective chart review was undertaken to identify reasons for referral, patient characteristics, outcome of referral and concurrent health problems...
January 13, 2018: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29330237/-the-hand-on-the-doorknob-visit-agenda-setting-by-complex-patients-and-their-primary-care-physicians
#5
Christine P Kowalski, Deanna B McQuillan, Neetu Chawla, Courtney Lyles, Andrea Altschuler, Connie S Uratsu, Elizabeth A Bayliss, Michele Heisler, Richard W Grant
BACKGROUND: Choosing which issues to discuss in the limited time available during primary care visits is an important task for complex patients with chronic conditions. DESIGN, SETTING, AND PARTICIPANTS: We conducted sequential interviews with complex patients (n = 40) and their primary care physicians (n = 17) from 3 different health systems to investigate how patients and physicians prepare for visits, how visit agendas are determined, and how discussion priorities are established during time-limited visits...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29327524/uttar-pradesh-association-of-physicians-of-india-position-statement-tobacco-use-and-metabolic-syndrome
#6
Yatan Pal Singh Balhara, Sanjay Kalra, Sarita Bajaj, Pooja Patnaik Kuppili, D Himanshu, Veerendra Atam, Kauser Usman, Veerendra Singh, Shyam Chand Chaudhary, S Chakravorty, Anupam Wakhlu, Jalees Fatma, Sanjay Tandon, Anuj Maheshwari, Abha Gupta, Anjum Parvez, Jaya Chakravarty, R R Chaudhary, A K Singh, K K Sawlani, Manoj Mathur, N K Soni, Om Kumari Gupta, Madhukar Rai, Sudhir Agarwal
Tobacco use is one of the main preventable causes of mortality and morbidity worldwide. The global disease burden due to tobacco use is huge with projected mortality of eight million lives per year by 2030. Metabolic syndrome (MS) is defined as a constellation of cardiovascular and endocrine risk factors such as insulin resistance, obesity, raised blood pressure, and abnormal lipid profile. The relationship between tobacco use and MS has been well established. Also, the causal association between tobacco use and development of individual components of MS is well established...
December 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29326842/barriers-to-peritoneal-dialysis-in-aboriginal-patients
#7
Anna T Mathew, Joonho Park, Mala Sachdeva, Manish M Sood, Karen Yeates
Background: Aboriginal people in Canada have an unduly high burden of end-stage kidney disease (ESKD) and many live in rural settings. Peritoneal dialysis (PD) is a home-based dialysis modality that may provide a valuable alternative to in-center hemodialysis which is relatively underutilized by the Aboriginal population. Objective: We aim to assess the barriers to PD utilization in Aboriginal patients with ESKD. Design: This article is a prospective observational cohort study...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29324363/documentation-integrity-authorship-functionalities-of-ehr-in-a-saudi-arabian-hospital
#8
Bakheet Aldosari, Abdullah Alanazi
This paper aims to evaluate the authorship, privacy capabilities and functions of QuadraMed and BestCare systems, implemented at the Ministry of National Guard Health Affairs (MNGHA) in Riyadh, Saudi Arabia. A survey was conducted by interviewing back-end users of the EMR system in the KAMC hospital to check the aforementioned systems' authorship capabilities. Both the systems scored the same, with the overall result being 146/165 including the compliance level, which represents 88% availability of all authorship functions...
December 25, 2017: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/29322173/association-of-surgical-practice-patterns-and-clinical-outcomes-with-surgeon-training-in-university-or-nonuniversity-based-residency-program
#9
Morgan M Sellers, Luke J Keele, Catherine E Sharoky, Christopher Wirtalla, Elizabeth A Bailey, Rachel R Kelz
Importance: Important metrics of residency program success include the clinical outcomes achieved by trainees after transitioning to practice. Previous studies have shown significant differences in reported training experiences of general surgery residents at nonuniversity-based residency (NUBR) and university-based residency (UBR) programs. Objective: To examine the differences in practice patterns and clinical outcomes between surgeons trained in NUBR and those trained in UBR programs...
January 10, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29321985/traditional-persian-medicine-and-management-of-metabolic-dysfunction-in-polycystic-ovary-syndrome
#10
REVIEW
Ayda Hosseinkhani, Nasrin Asadi, Mehdi Pasalar, Mohammad M Zarshenas
Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of reproductive age. Its cause is unknown and it remains the most enigmatic of reproductive disorders. The extant written documents of Traditional Persian Medicine (TPM) - with holistic approaches towards human health - contain remedies used for centuries. Before further experimental research on any of these treatments, it is appropriate to study current related scientific evidence on their possible pharmacological actions. This work aims to study PCOS and its treatments in TPM...
January 2018: Journal of Traditional and Complementary Medicine
https://www.readbyqxmd.com/read/29321134/efficacy-of-a-chronic-care-based-intervention-on-secondary-stroke-prevention-among-vulnerable-stroke-survivors-a-randomized-controlled-trial
#11
Eric M Cheng, William E Cunningham, Amytis Towfighi, Nerses Sanossian, Robert J Bryg, Thomas L Anderson, Frances Barry, Susan M Douglas, Lillie Hudson, Monica Ayala-Rivera, Jeffrey J Guterman, Sandra Gross-Schulman, Sylvia Beanes, Andrea S Jones, Honghu Liu, Barbara G Vickrey
BACKGROUND: Disparities of care among stroke survivors are well documented. Effective interventions to improve recurrent stroke preventative care in vulnerable populations are lacking. METHODS AND RESULTS: In a randomized controlled trial, we tested the efficacy of components of a chronic care model-based intervention versus usual care among 404 subjects having an ischemic stroke or transient ischemic attack within 90 days of enrollment and receiving care within the Los Angeles public healthcare system...
January 2018: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29317936/what-does-it-take-to-change-practice-perspectives-of-pharmacists-in-ontario
#12
Paul A M Gregory, Beatriz Teixeira, Zubin Austin
Background: This is a time of rapid change in the profession of pharmacy. Anecdotally, there are concerns that the pace, extent and rate of practice evolution are lagging. There is little evidence documenting the influencers and mechanisms that drive practice changes forward in pharmacy in Canada. Methods: An exploratory qualitative method was selected, using both one-on-one interviews with self-categorized typical pharmacists and larger focus groups to provide context and confirmation of themes generated through interviews...
January 2018: Canadian Pharmacists Journal: CPJ, Revue des Pharmaciens du Canada: RPC
https://www.readbyqxmd.com/read/29315106/zurich-to-berlin-where-are-we-now-with-the-concussion-in-sport-group
#13
Margaret E Pusateri, Brandon J Hockenberry, Christopher A McGrew
The Concussion in Sport Group recently published its highly anticipated fifth consensus statement on sports-related concussion. The latest iteration features a new organizational format-the "11 Rs" and has input from a wider range of health care professionals, organizations, and experts in the field from both the sport concussion area and from related areas outside of sport. The stated objective of this current document is to "build on the principles outlined in previous statements and develop further conceptual understanding of sports-related concussion...
January 2018: Current Sports Medicine Reports
https://www.readbyqxmd.com/read/29314288/the-limitations-of-dermoscopy-false-positive-and-false-negative-tumors
#14
REVIEW
V Papageorgiou, Z Apalla, E Sotiriou, C Papageorgiou, E Lazaridou, S Vakirlis, D Ioannides, A Lallas
Dermoscopy has been documented to increase the diagnostic accuracy of clinicians evaluating skin tumors, improving their ability to detect skin cancer and better recognize benign moles. However, dermoscopically "false positive" and "false negative" tumors do exist. False positive diagnosis usually leads to unnecessary excisions. False negative diagnosis is much more dangerous, since it might result in overlooking a cancer, with severe undesirable consequences for the patient and the physician. Therefore, management strategies should mainly focus on addressing the risk of dermoscopically false negative tumors...
January 5, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/29310996/appropriateness-of-statin-prescription-in-the-elderly
#15
M Ruscica, C Macchi, C Pavanello, A Corsini, A Sahebkar, C R Sirtori
Statins, the most widely used drugs in the Western world, have become a pivotal component in the primary and secondary prevention of vascular diseases. Although benefits have been well documented in younger-than-75-year-old individuals, the value of statins in people aged >75years and over is controversial. The CTT meta-analysis calculated an absolute risk reduction of 0.6%/year per 38.7mg/dl reduction in LDL-C levels in patients aged >75years, that would translate into a number needed to treat of 167...
January 5, 2018: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/29306373/benefit-risk-communication-in-paediatric-imaging-what-do-referring-physicians-radiographers-and-radiologists-think-say-and-do
#16
J L Portelli, J P McNulty, P Bezzina, L Rainford
INTRODUCTION: To assess how referrers and practitioners disclose benefit-risk information about medical imaging examinations to paediatric patients and their parents/guardians; to gauge their confidence in doing so; and to seek their opinion about who is responsible for disclosing such information. METHODS: This study followed on from a previously published study, with a questionnaire distributed in staggered phases to 146 radiographers, 22 radiology practitioners, 55 emergency physicians and 43 paediatricians at a primary paediatric referral centre in Malta...
February 2018: Radiography
https://www.readbyqxmd.com/read/29305321/factors-associated-with-symptom-relief-in-end-of-life-care-in-residential-care-homes-a-national-register-based-study
#17
Sofia Andersson, Kristofer Årestedt, Olav Lindqvist, Carl-Johan Fürst, Margareta Brännström
BACKGROUND: Residential care homes (RCHs) are a common place of death. Previous studies have reported a high prevalence of symptoms such as pain and shortness of breath among residents in the last week of life. AIM: To explore the presence of symptoms and symptom relief, and identify factors associated with symptom relief of pain, nausea, anxiety, and shortness of breath among RCH residents in end-of-life care. METHOD: The data consisted of all expected deaths at RCHs registered in the Swedish Register of Palliative Care (n=22 855)...
January 2, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29304160/a-retrospective-review-of-vital-signs-and-clinical-outcomes-of-febrile-infants-younger-than-3-months-old-presenting-to-the-emergency-department
#18
Shu-Ling Chong, Gene Yong-Kwang Ong, Wendy Yi Wen Chin, John Mingzhou Chua, Praseetha Nair, Alicia Shu Zhen Ong, Kee Chong Ng, Ian Maconochie
OBJECTIVES: Febrile infants younger than 3 months old present a diagnostic dilemma to the emergency physician. We aim to describe a large population of febrile infants less than 3 months old presenting to a pediatric emergency department (ED) and to assess the performance of current heart rate guidelines in the prediction of serious infections (SI). MATERIALS AND METHODS: We performed a retrospective review of febrile infants younger than 3 months old, between March 2015 and Feb 2016, in a large tertiary pediatric ED...
2018: PloS One
https://www.readbyqxmd.com/read/29303424/seizing-the-opportunity-exploring-barriers-to-use-of-transmucosal-midazolam-in-hospice-patients
#19
Samuel J Perna, James M Rhinewalt, Erin R Currie
BACKGROUND: Status epilepticus seizures are distressing events for hospice and palliative care patients. Currently, rectal diazepam is the only abortive therapy approved by the U.S. Food and Drug Administration for seizures occurring out of hospital. However, transmucosal (buccal and intranasal) midazolam hydrochloride is a less expensive, equally effective, and a more socially acceptable alternative. OBJECTIVE: To explore the use of transmucosal midazolam in out-of-hospital hospice patients in the State of Alabama...
January 5, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29302885/diagnostic-evaluation-of-patients-presenting-to-primary-care-with-rectal-bleeding
#20
Sanja Percac-Lima, Lydia E Pace, Kevin H Nguyen, Charis N Crofton, Katharine A Normandin, Sara J Singer, Meredith B Rosenthal, Alyna T Chien
BACKGROUND: Rectal bleeding is a common, frequently benign problem that can also be an early sign of colorectal cancer. Diagnostic evaluation for rectal bleeding is complex, and clinical practice may deviate from available guidelines. OBJECTIVE: To assess the degree to which primary care physicians document risk factors for colorectal cancer among patients with rectal bleeding and order colonoscopies when indicated, and the likelihood of physicians ordering and patients receiving recommended colonoscopies based on demographic characteristics, visit patterns, and clinical presentations...
January 4, 2018: Journal of General Internal Medicine
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